18 



Scientific Proceedings (77). 



washed with ether and sterile salt solution, and the ends closed. 

 All of these dogs died within 24-48 hours, with the usual symptoms 

 of toxemia. In all cases the loops, on autopsy, were greatly 

 distended, and black, or covered with purple blotches. Four of 

 the loops had perforated. In every case the fluid in the loops 

 contained B. coli, other baccilli, and cocci. The failure to get 

 dogs thus operated to live on in good condition appears to be 

 due to the occlusion of the circulation in the loops by distension 

 from the duodenal secretion, subsequent necrosis, and bacterial 

 toxemia. 



In nine dogs the isolated segment of jejunum was washed with 

 70 per cent, alcohol or 2 per cent, lysol and sterile water or salt 

 solution. All the dogs died within 4-18 days with perforation 

 of the loop and peritonitis. 



In four dogs a segment of the upper jejunum was washed in 

 sterile water and replaced in the abdominal cavity without closing 

 the ends. These dogs lived indefinitely without showing any 

 symptoms. Five weeks after the operation a second laparatomy 

 was performed on two of the dogs and it was found that both ends 

 of the loops were closed by adhesions. The mucosa of the loop 

 was normal and the fluid in the loops sterile. 



In six dogs an isolated segment of the duodenum (just below 

 the posterior pancreatic duct) was replaced in the abdominal 

 cavity without washing the lumen or closing the ends. Three of 

 these dogs died within five days of general peritonitis. The other 

 three dogs lived indefinitely without showing any symptoms. One 

 dog was inspected 20 days, and another 30 days after the first 

 operation. In both cases the ends of the loops were completely 

 closed by adhesions, the lumen somewhat distended with a sterile 

 fluid, and the mucosa and muscularis normal. It is clear that the 

 duodenal and jejunal secretions are not toxic when poured directly 

 into the abdominal cavity. 



The experiments to date, comprising work on 96 dogs, seem 

 to warrant the following conclusions: 



1. Closed intestinal loops in which the bacteria are first re- 

 moved are not incompatible with life. 



2. Closed intestinal loops in which bacteria are present but in 

 which tissue necrosis is prevented are not incompatible with life. 



